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CLEARING, GRUBBING, GRADING, AND EXCAVATION PERMIT <br />Type or print clearly in ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />Public Works <br />Everett, Washington <br />APPLICANT (UnJersigned) AND FIRM REPRESENTED, IF <br />HEREBY APPLIES FOR PERMISSION TO (ldentify Quantities) <br />FOR <br />OFFICE AT THE FOLLOWING LOCATION (S) <br />USE <br />ONLY <br />PERMIT NO. <br />DETAILED, SCALED DNAWING OF WORK TO BE DONE, ATTACH 4 COPIES <br />ATTACH LEGAL DESCRIPTIONS <br />PERMIT IS VALID FOR 120 DAYS <br />(May be extended upon writlen approval trom Public Works) <br />A NEW PERMIT IS REQUIRED IF WORK <br />HAS NOT BEGUN WITHIN RO DAYS <br />THIS PERMIT TO BE POSTED ON JOB SITE. <br />CALL FOR INSPECTION 259�8871 <br />24 HOURS BEFORE BEGINNING OPERt\TION <br />PLANNING/S[PA APPROVAL <br />for Constniction (PW) <br />Issued (Bldg. Dept) n��� <br />llpp�ovrd as CnnsUuc�ed (�'�NI <br />r <br />��G �� i.< l�� <br />everet�t <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless ihe City of Everett from any and all <br />claims lor damages, costs, expenses, or causes of <br />action that may arise because of the clenring, <br />qrubbicg, grading, and/or excavation activities <br />hcreto applied for and funher agrees to comply <br />with all provisions of this permit. <br />�;•iry�atwe o( ApplicanUDate of Application <br />City <br />Telephnne Nwnbcr <br />?�n <br />N�emau� <br />� <br />